Addressing threats to health care's core values, especially those stemming from concentration and abuse of power. Advocating for accountability, integrity, transparency, honesty and ethics in leadership and governance of health care.

Monday, July 31, 2006

"Repositioning and Rebranding" While UMDNJ Burns (Money)

The management of the University of Medicine and Dentistry of New Jersey (UMDNJ) was back in the harsh media spotlight again. UMDNJ has appeared frequently in posts on this blog. The university now is operating under a federal deferred prosecution agreement with the supervision of a federal monitor (see recent posts here, here, here and here.) We had previously discussed allegations that UMDNJ had offered no-bid contracts, at times requiring no work, to the politically connected; had paid for lobbyists and made political contributions, even though UMDNJ is a state institution; and seemed to be run by political bosses rather than health care professionals. (See post here, with links to previous posts.) Most recently, the costs of all these management shenanigans was estimated to be a whopping $243 million (see post here).

the federal monitor overseeing the school concluded [trustee] Sterritt had committed ethical and legal violations by pressuring university officials to hire his brother, an admitted alcoholic who lost his license to practice law because of misconduct.

The monitor, former federal Judge Herbert J. Stern, said in the report that staffers within the university's human resources department complained that Sterritt was 'very involved' and 'persistent' in an effort to find his brother a position at UMDNJ -- which they considered unprofessional and unacceptable interference.

The report said UMDNJ staff felt pressure to find employment for Sterritt's brother 'at all costs,' noting he was eventually hired after the job requirements were loosened so he could qualify. However, he was paid at the higher salary of the titled position before it was downgraded, according to the monitor.

The article also cataloged all the other UMDNJ leaders who have left:

In the past eight months, the university has lost its president, who was pressured to leave by Corzine; three other trustees who left after tougher ethics rules were put in place banning even casual business relationships with the school; the dean of the university's School of Osteopathic Medicine and the university's senior vice president for academic affairs, who were both accused of abusing travel and expense accounts; and a senior associate dean, who was fired for abusing his position to help himself, friends and family -- including wielding his influence to get a daughter into medical school.

Meanwhile, the repurcussions of the university's huge financial losses continue. The Star-Ledger also reported that the university will lay off more than 100 staff, raise tuition at the medical and dental schools by four percent, and delay the opening of a new out-patient cancer center at the Newark campus. The interim president warned of "longer waits in the hospital's emergency room for non-critical cases. He predicted patients also will have to wait longer to get appointments at the hospital's clinics, as well as face delays for elective surgery."

But amazingly, despite these cuts, the Star-Ledger further reported that UMDNJ leadership had planned to spend about $2.5 million on a "marketing campaign to spruce up the image of the state's scandal-plagued medical university." This was "the second time the governor's office has killed an image campaign by UMDNJ that it found to be ill-timed or ill-conceived. An earlier media effort was quashed in January under pressure by then-Gov. Richard Codey." (See post here.) " The new plan was to resurrect elements of that plan, in a so-called 'repositioning and rebranding campaign' to highlight UMDNJ's research, aimed at attracting researchers, students and patients to the university's clinical services and its teaching hospital. It included many of the television commercials and print advertisements that had already been produced before the lid had been put on the original marketing effort, officials said." The plan was all set to go forward, but after the Star-Ledger asked the state governor's office to comment on it, "the university was ordered to put the ad campaign on hold indefinitely. That request was made by Stuart Rabner, the governor's chief counsel, who told the university that while image improvement was important for UMDNJ, the $2.5 million expenditure would seem inappropriate at a time when the university was cutting jobs and programs to help address a $25.5 million budget deficit at UMDNJ's University Hospital. "

Ok, UMDNJ is operating under a deferred prosecution agreement, has lost $243 million to mismanagement and other administrative misadventures, has seen the departure of many of its top leaders, is running a deficit and forced to make severe cutbacks. So how do the current leaders respond? - by trying to run a marketing campaign of "repositioning and rebranding?" Is there no problem that can't be papered over by a little repositioning and rebranding?

One correspondent responded to the problems at one of the large pharmaceutical companies by wondering if that company had become "a marketing company that happens to make drugs." Has UMDNJ become "a marketing company that happens to be a health care university?"

Once again, the problem appears to be corporate culture. Health care organizations have attracted leaders who are more interested in marketing than in their fundamental missions. UMDNJ needs leaders who put mission before marketing. Leaders' papering over problems is what lead the university to its current sorry state.

As a business person I see this corporate culture permeating our suburban medical practices. As a patient I have been subject to some very blatant and tacky sales presentations. Socially, I have been disappointed in the behavior of doctors who's only topic of discussion is how to game the system, or per unit cash flows based on patient profiles.

Remember that in a sales organization the salesman is never wrong, it is the customers fault for not understanding the great product we are selling. In the medical field we are called noncompliant and pushed aside for not believing everything we are told.

One must question a doctor's motives when we see a nationally recognized doctor promoting a statin in a full page, full color ad in the WSJ.

I also know an Inside story..Some of the Senior managers at UMDNJ Cancer Research - Phase -1 research group, hardly work 3 days a week. The unfortunate things is that the managment is exploiting their employees...

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